AB0853 ENDOTHELIAL DISFUNCTION MARKERS CAN BE REDUCED IN SYSTEMIC SCLEROSIS PATIENTS BY NUTRITIONAL TREATMENT
Authors: A. Wojteczek, Z. Zdrojewski, S. Małgorzewicz
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Systemic sclerosis is a chronic autoimmune disease which is represented by progressive fibrosis, vascular impairment and immune abnormalities. In recent years metabolic and endothelial factors were reported as elements which play role in pathogenesis of systemic sclerosis (SSc). Adipokines, mediators secreted by adpiose tissue, depends on fat mass and nutritional status. Ghrelin, a gut hormone, is a key regulator of metabolism of glucose, meal initiation and appetite. Another metabolic factor myostatin, is a myokine produced by muscles and is negative regulator of muscle growth. Endothelial factors auch as endothelin 1 (endogenous vasoconstrictor, mainly secreted by endothelial cells) and asymmetric dimethylarginine (ADMA, endogenous nitric oxide inhibitor) are important markers for vascular dysfunction. <h3>Objectives</h3> The aim of the study was to evaluate serum concentration of ghrelin, myostatin, adiponectin, wisfatin, chemerin, leptin, interleukin 6 (IL-6), endothelin 1 and ADMA in relation to the nutritional status of patients with SSc, and impact of nutritional treatmet on their levels. <h3>Methods</h3> Study population consisted of 56 SSc patients (47 females, 9 males) and 49 healthy persons (42 females and 7 males). Demographic and clinical data were recorded. Assessment of nutrition based on 7-SGA and laboratory tests were done. <h3>Results</h3> SSc patients had significantly higher levels of nonacylated ghrelin (478,5±289,9 vs 347,7 ±294,8 pg/ml; p=0,018), IL-6 (30,7±29,7 vs 3,16±26,15 ng/ml; p=0,001), endothelin 1 (2,71±1,67 vs 1,96±1,02 pg/ml; p=0,002) and ADMA (1,37±0,45 vs 1,23±0,23 um/l; p=0,025) than control population. From 56 SSc patients 40 (71%) were well-nourished and 16 (29%) had nutritional disbalance. In those subgroups significantly higher levels of endothelin 1 (3,32±2,02 vs 2,58±1,71 pg/ml, p=0,043) and ADMA (3,32±2,02 vs 2,58±1,71 um/l, p=0,043) had malnourished patients. No statistically significant results in other parameters were observed. Dietary recommendations and high protein oral nutritional suplement (200 ml/day, containing 250 kcal and 19 g of protein) were given for 3 months to all 16 SSc patients with nutritional disorder. After 3 and 12 months patients were re-evaluated. Significantly higher levels of myostatin were noticed after 1 year after initial assesment (p=0,001). Opposite effect were seen with endothelin 1 and wisfatin, where in last evaluation both gain the lowest results (p&lt;0,001,p=0,039). <h3>Conclusion</h3> Higher levels of endothelin 1 and ADMA confirm that vascular damage is crucial in SSc patients. Proper nutritional treatment in undernourished SSc patients can reduce levels of markers involved in endothelial disfunction, such as endothelin 1 and wisafatin. <h3>References</h3> [1]Wan G, Wang L, Zhang G, Zhang J, Lu Y, Li J, Yi X. Effects of probiotics combined with early enteral nutrition on endothelin-1 and C-reactive protein levels and prognosis in patients with severe traumatic brain injury. J Int Med Res. 2020 Mar;48(3):300060519888112. [2]Żółkiewicz, J., Stochmal, A. &amp; Rudnicka, L. The role of adipokines in systemic sclerosis: a missing link?. Arch Dermatol Res 311, 251–263 (2019). <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.